| NPI | 1700547908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 177547) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 185285) |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2023-06-21 |